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Mid-level executives are confronted with many dilemma situations, in which they are forced to decide between conflicting options, none of them leading to the desired result. If they fail to cope with them constructively, their individual risk for mental strains increases (Gerlmaier and Latniak, 2013). Initial findings focusing on executives in industry (Bossmann, 2020) show that fostering effective dilemma management in executives is a preventive factor against stress-related diseases. Yet, there is little empirical research that evaluates the contribution of dilemma management training on leadership’s mental health prevention in hospitals. This study aims to examine whether such a training program, adapted to current working conditions in German hospitals, promotes mid-level executives’ mental health.

A 10-month training program was administered to N = 69 senior physicians, senior nurses and senior service and administrative staff in four hospitals. To evaluate training effects on perceived stress reactivity, on cognitive and emotional irritation over time as well as the effects of the training dose on these results, participants’ self-reported measures were collected at four points in time: before (t0), during (t1), immediately after (t2) and three months after the intervention (t3).

Overall, participants showed less cognitive irritation and perceived stress reactivity over time. However, their emotional irritation did not change significantly. The dose of training participation did not moderate these results.

This paper contributes to the prevention of stress-related diseases and the promotion of sensemaking in mid-level executives’ dilemma management routine in the face of increasingly aggravating working conditions due to financial restrictions in the German health-care system. Findings of this study are explained in greater depth using previously reported qualitative data from the same research project.

The purpose of this paper is to explore the dilemmas that challenge reputation management in the context of higher education (HE).

The paper introduces one Finnish multidisciplinary master's degree programme as a case in point. The empirical data comprises a student survey and semi-structured interviews with internal and external stakeholders whose work relates to the master's degree programme in question.

The findings identify different types of dilemmas arising from collaboration between stakeholders of HE.

The paper demonstrates how the dilemma-reconciliation method can be used to enhance reputation management in HE.

The novelty of the paper is in applying dilemma theory (Hampden-Turner and Trompenaars, 2000) in parallel with reputation theories. Dilemma theory attributes reputation risks to conflicting aims.

The purpose of this paper is to characterize issues related to head nurses’ decision making when managing ethical dilemmas.

The study is qualitative descriptive, in which researchers stay close to the data. The data were collected in the format of unstructured written reflections. Inductive conventional latent qualitative content analysis was applied to the data.

The issues of head nurses’ management of decision making in ethical dilemmas relate to the following aspects: taking risks in deviating from the formalities, balancing power and humaneness, maintaining the professional hierarchy, managing resistance to change, managing with limited options, and experiencing the decline of nurse’s professional and/or human dignity.

Reflections in written form were preferred to semi-structured interviews and the researchers were unable to contact the participants directly and to ask additional questions. All the reflections were produced in a language other than English.

The issues of head nurses’ management of decision making in ethical dilemmas reveal the gap between societal expectations and the opportunities to improve nursing leadership in health care organizations.

The issues of head nurses’ decision making when managing ethical dilemmas are related to contexts that reflect the attitudes of society and health care system toward nursing management.

The study adds to the understanding of issues of the management of decision making in ethical dilemmas. It is an ongoing systematic process that encourages head nurses to learn from practice and manage the quality of care by empowering themselves and nurses to take responsibility for leadership.

The purpose of this paper is to examine dilemmas encountered by kindergarten head teachers with the further aim of developing their capability to recognise and resolve “leadership dilemmas”.

Action research was used to conduct a three‐phase study involving 16 kindergarten head teachers and six system managers (within the Auckland region). A reconnaissance phase investigated the nature of perceived dilemmas and typical responses. In the second phase, an intervention that provided participants with both the theory and practice skills was implemented. A third phase of research evaluated the extent to which change had occurred.

The reconnaissance phase findings (pre‐learning questionnaire) confirm the incidence of dilemmas in kindergarten settings. The data show that, while leaders could identify issues that signalled the presence of dilemmas, they were unable to articulate leadership dilemmas clearly or confront them successfully. A professional development intervention was evaluated using a post‐learning questionnaire. There is evidence that these leaders were better able to recognise and articulate the leadership dilemmas they encountered in performance management settings. The findings show that participants are able to analyse their responses to these dilemmas by relating these to the theory base and indicating where they believe there is need for further learning. In summary, the intervention did change participants' practice but the study is limited by its inability to gauge internalisation of learning and study its implementation. For this to occur another cycle of action research is required.

The paper is original in that it studies the practices of leaders in relation to resolving dilemmas which arise when leaders manage the performance of staff. If leaders have an understanding of the theory and skills they need to address these tension‐laden problems, they could positively influence the quality of teaching and learning through leadership practices.

The failure of schools between 1990 and 1995, to respond to the imperative to establish systems for staff appraisal resulted in the Ministry of Education in New Zealand prescribing guidelines for schools to follow from 1996 onwards. This paper explores forces which shaped national policy in the framework of the reform movement, describes the policy development process and a national training programme for its introduction and examines challenges presented for principals who are expected to be accountable for policy implementation. National policy (which frames problems and solutions in structural terms) is analysed to show how it can fail to address dilemmas at the heart of staff appraisal activity. Problems inherent in attempting to mesh dual purposes of appraisal are identified, and the requirements of a “dilemma management” approach are explained in relation to the role of the principal.

Designing learning experiences that mimic real-life contexts has always been a challenge for leadership educators. As a result, many educators in leadership courses rely on studies of leadership perspectives, selfassessment activities, and textbook case analysis. However, many educators also successfully design microlevel processes and interactions that offer students the opportunity to experience the dynamics of power and influence whereby they practice leadership. Others explore the daunting challenges of placing students in various organizations to practice leadership. This latter type of practicing leadership is often full of challenges because of the reluctance of organizations to allow practicing students in decision making processes. In this paper, I present a two-week teaching segment in which leader dilemmas are used as inputs for practicing leadership in micro-level processes. The segment is designed in such a way that it mimics real life group dynamics, problem solving, and decision dilemmas. The objective is to provide a context wherein students practice micro-influence making as they experience the complexity of group life and, at the same time, learn to reflect on their learning, emotion, and the potential capacity to lead and follow.

The purpose of this paper is to investigate how healthcare professionals understand a new organisational brand and examine the ideas discussed in relation to it within healthcare organisations.

The research is based on a discursive approach that facilitates understanding how the informants perceived a new organisation brand and how that might shape their activities in the enterprise.

The study identified four distinct interpretative repertoires: the organisational brand as an economic solution, the magic wand, the factory and a servant to the customer. The new brand was understood in terms of economic and business-like functions marked by external branding and its signs (logos, etc.). The brand is not communicated to patients or colleagues and the factory metaphor is applied to work practices. Hence, several potential dilemmas arise concerning the brand promise, customer expectations, economic and efficiency gains and the professional values of employees.

Adoption of private-sector practices in semi-public or public-sector organisations is common. This study focuses on how private-sector ideas diffuse into the organisations and how they are translated within them.

The authors suggest a stronger emphasis on internal branding as a reconciliation to enhance legitimacy, high-quality customer service and staff wellbeing.

Theoretically, the unique contribution of the study is drawing upon healthcare branding, dilemma theory and discursive institutionalism in its interpretation. Consequently, it demonstrates how ideas about the brand and public healthcare are translated and communicated in the examined discourses and how those ideas reconstruct understanding and change behaviour within the organisations.

The purpose of this paper is to question the usefulness of Euro-Western concepts of principled ethical behaviour for school leaders in non-Euro-Western countries by examining the dilemmas faced by Kenyan educational leaders.

A single, multi-site case study methodological approach was used, and data gathered by means of semi-structured interviews with stakeholders: school principals, boards of governors, heads of department, school bursars and parents.

Findings highlighted the importance of contextual variables in influencing leaders’ decisions, indicative of the tension between liberal and communitarian ethical approaches. Although similar dilemmas were encountered to those working in euro-western contexts, Kenyan educational leaders faced the additional challenge of working with cultural values of Ubuntu: care for the whole community, harmonious working relationships, loyalty to one’s kin and respect of seniority. Furthermore, the problems they encountered were often life-threatening resulting from poverty, and HIV/Aids.

This paper contributes to the literature on ethics in educational leadership by proposing that the adoption of euro-western ethical standards and perspectives in non-Euro-Western countries is problematic, unless mitigated by a dialogic approach.

The article analyses some of the reasons for the difficulties in designing and managing channels of distribution. In particular it argues that an important dilemma likely to be faced by channel managers is the potential conflict between maintaining stable channel relationships whilst seeking to take advantage of channel opportunities.

The purpose of this paper is to improve the understanding of the dilemma of institutional duality (ID) confronting multinational corporations and to propose a workable solution for this problem.

The author has searched the literature using several terms directly related to the dilemma of ID and multinational firms.

The findings reveal that to attain “legitimacy”, subsidiaries strive to balance institutional pressures stemming from external environments in the host country and their parent organizations. Understanding institutional theories of multinational corporations enables the subsidiaries to manage external pressures. ID impact varies among subsidiaries, depending on institutional contexts and internal strategies of subsidiaries.

An “institutional duality incidence model” portraying how dual institutions make “legitimacy” problematic for subsidiaries is proposed. A framework for identifying factors generating ID dilemma and their management approach is also proposed. It is concluded that a multinational corporation that recognizes ID as a central concern is more likely to achieve and maintain a higher level of harmony with its subsidiaries and host countries.